On the proper use of available anti-malarial drugs in France.

French medical practitioners have at their disposal several antimalarial dr ugs for giving chemoprophylaxis to people travelling to a malaria endemic c ountry or treating an imported malaria case in a patient. The choice depend s on the contre-indications and indications of each drug, essentially subor dinated to the presence and level of Plasmodium falciparum chemosensivity i n the visited area. For prevention, chloroquine alone can be taken in the areas where P. falcip arum is absent or not chloroquine resistant; elsewhere, the choice between chloroquine/proguanil or mefloquine depends on knowing the prevalence and l evel of falciparum chloroquine resistance in these areas. For treatment, the only indications of chloroquine are imported malaria cas es either due to P vivax, P. ovate or P. malariae, or caused by P. falcipar um contracted in one of the rare countries where the species is still sensi tive to chloroquine. For uncomplicated falciparum malaria cases acquired in a chemoresistance ar ea, mefloquine, halofantrine, sulfadoxine-pyrimethamine or oral quinine is selected depending on the observed chemoprophylaxis, the contra-indications and the suspicion of chemoresistance type. Whatever the provenance area, P. falciparum in a patient with one or severa l serious symptoms or possibly profuse vomiting is treated by intraveinous quinine, associated with tetracycline ii the patient tomes from an area kno wn for a low quinine sensitivity of this species. The spectrum of falciparum malaria treatment has recently broadened to incl ude new drugs such as artemisinin, artemether or atovaquone/proguanil, the latter being as yet unauthorized in France.